A Manual of Pathology, by Joseph Coats, M.D. Fifth Edition, Revised throughout by L. R. Sutherland, M.B. With 729 Illustrations and 2 Coloured Plates. London: Longmans, Green & Co. 1903. (28s. net.) A System of Physiologic Therapeutics, Edited by Solomon Solis Cohen, A.M., M.D. Volume VIII: Rest, Mental Therapeutics, Suggestion, by Francis X. Dercum, M.D., Ph.D. London: Rebman, Limited. 1903. (12s. 6d. net.) First Aid in Accidents, by Collie and Wightman. London: George Gill & Sons, Limited. (6d. net.) The Care of Infants: A Manual for Mothers and Nurses, by Sophia Jex-Blake, M.D. Second Edition. Edinburgh: G. A. Morton. 1903. (1s. net.) Diseases of Women, by Alfred Lewis Galabin, M.A., M.D. Sixth Edition, much Enlarged, with 284 Illustrations. London : J. & A. Churchill. 1903. (16s. net.) Surgical Lectures and Essays, by A. Marmaduke Sheild, M. B. Cantab., F.R.C.S. London: The Medical Publishing Co., Ltd. A Text-Book of Obstetrics, by J. Clarence Webster, M.D.Edin., F.R.C.P.E., F.R.S.E. With 383 Illustrations (23 of them in Colours). London: W. B. Saunders & Co. 1903. (21s. net.) A Text-Book of Operative Surgery, written for Students and Practitioners, by Warren Stone Bickham, Phar. M., M.D. With 559 Illustrations. London: W. B. Saunders & Co. 1903. (25s. net.) The Rearing of the Infant; A Homely Treatise for the Home, by Robert Guy Kellett. Camberwell: A. H. Jones. 1903. (6d. net.) Practical Text-Book of Midwifery for Nurses, by Robert Jardine, M.D.Edin. With 39 Illustrations. Second Edition. Edinburgh William F. Clay. 1903. (6s.) The Medical Examination for Life Assurance, with Remarks on the Selection of an Office, by F. de Havilland Hall, M.D. Third Edition, Greatly Enlarged. Bristol John Wright & Co. 1903. (4s. net.) An Atlas of Human Anatomy for Students and Practitioners, by Carl Toldt, M.D., assisted by Alois Dalla Rosa, M.D. Translated from the Third German Edition, and adapted to English and American and International Terminology, by M. Eden Paul, M.D. First Section: A. The Regions of the Human Body. B. Osteology (Figures 1 to 377 and Index). London: Rebman, Limited. 1903. (9s. net.) Essentials of Pelvic Diagnosis, with Illustrative Cases, by E. Stanmore Bishop, F.R.C.S.Eng., and an Appendix on Examination of Blood, &c., by Chas. H. Melland, M.D. Bristol John Wright & Co. 1903. (9s. 6d. net.) THE GLASGOW MEDICAL JOURNAL. No VI. DECEMBER, 1903. ORIGINAL ARTICLES. REPORT ON CONTINENTAL MATERNITY HOSPITALS SUBMITTED TO THE DIRECTORS OF THE GLASGOW MATERNITY HOSPITAL. BY DONALD J. MACKINTOSH, M.B., M.V.O., AT the request of your directors, along with Dr. Jardine, Dr. Munro Kerr, and Mr. Bryden, architect, I visited various hospitals on the Continent with the view of obtaining information which might prove helpful in preparing the plans for a new maternity hospital in Glasgow. I would here express our great appreciation of the kindness and assistance extended to us by Dr. A. Warden, of Paris, and the professors and doctors of the various hospitals we visited. In all, we visited eleven maternity hospitals. After going over three hospitals in Paris, we visited the hospitals in Basle, Freiburg, Heidelberg, Halle, Leipzig, Dresden, Berlin, and Hanover. In a new maternity hospital, it would be well to provide a small room near the patients' waiting-room, where the house surgeon could take the history of the case and make a preliminary examination of the patient in order to decide whether the patient should be admitted to the examination-room or be sent direct to the septic block. Near the patients' waitingroom should be placed a patients' undressing-room, a good-sized No. 6. 2 C Vol. LX. bathroom, and an examination-room with tiled walls and tiled floor, as this room may require to be used as a delivery-room in a case of emergency. The entrance bathroom should have a marble slab, on which patients could be thoroughly washed; this would prevent the possibility of infecting the parts from soiled water in the bath. Two lifts should be provided, one of them large enough to take a bed from one flat to another. Two labour-rooms with two beds in each are necessary. These rooms must be well lit, and the walls and floors tiled, and there should be a sterilising-room adjoining. A room for washing the children would be a great advantage. At least one portable bath should be provided on each flat. The isolation block should be separate from the main building, and be complete in itself, with separate operatingroom and accommodation for its own staff. A large disinfector should be provided in order that every mattress may be thoroughly disinfected after use. All the septic linen should be collected in a separate room, steeped in some disinfectant, and boiled before it reaches the washhouse proper. We found that maternity and gynæcological patients could be treated in the same building without any disadvantage if these precautions were taken, and proper accommodation provided for septic and suspicious cases. One general kitchen would serve for the whole hospital. The large wards should not have more than eight beds in each, and the doors should be wide enough to allow of a bed being taken out and in with ease; one or two smaller rooms should be provided on each flat for special cases. A goodsized room is required near the disinfector for the storage of patients' own clothes, also a room for the repair and storage of linen and mattresses. A well-lit laboratory and small museum should also be provided. Radiators for heating the wards and corridors should be of the simplest design; they should be hung well out from the wall, and at least nine inches free of the floor, in order that they may be easily kept clean. Open fires in the wards are not necessary if the heating and ventilation is efficiently carried out. The absence of open fires avoids much dust, and with radiators the wards can be kept at a uniform temperature. PARIS: MATERNITY DE BEAUJON. The Beaujon is a general hospital with a new maternity pavilion having a separate entrance from the street. Arrangements for the admission of patients to the maternity department. When a patient arrives in the ambulance, her temperature is taken. If her temperature is febrile, the patient is at once taken to the isolation block adjoining. If there is no elevation of temperature, the patient is taken to the examination-room in the maternity block. The examination-room is a large, well-lit room, with three beds, having fixed-in washhand basins. (This room is also used for the examination of patients who return to report themselves, or who seek advice previous to admission.) From the examination-room the patient is taken to the entrance bathroom, where she is bathed, and her own clothes are either sent home with a friend or taken to the disinfector and afterwards stored outside the main building. (This bathroom is much too small, and is badly placed.) The patient is then taken to the labour-room. The labour or delivery-room is a large, well-lit room on main floor with four beds. On side wall there are fixed washhand basins and a sink, and in centre of floor a large glass table with steriliser. Adjoining the labour-room on one side is a small bathroom with a portable bath and small child's bath; this portable bath is sometimes used to help on labour. On the other side of corridor is a small operating-room, with entrance from labour-room as well as door into main corridor. (Patients are kept two hours in labour-room after delivery before being removed to the ward.) Near the main entrance, besides the rooms mentioned, are a cloak-room for students, with washhand basins, two lecture-rooms, one large and one smaller, a head nurse's room, a linen-room, and a ward kitchen. Opposite the main entrance and in the centre of the building there is the main staircase, with a large hoist in its centre, leading to the three flats above. On the first flat there is a doctor's room, wards with ten beds, also two smaller rooms, with two beds in one room and one bed in another. There is a room with one bed for a wet nurse, and an incubator-room. The incubators are made by Richards, of Paris; they are heated with gas, and are ventilated by means of a ventilating pipe to the window. There is one bath and two w.c.s on each flat, and accommodation for linen. The flat above is similar, except that the wet nurse's room and incubator-room are used as a sitting-room for the midwives. It is lined with lockers. The whole of the top flat is divided up into nurses' rooms on the one side, and midwives' and servants' rooms on the other. The nurses' rooms are 12 ft. by 9 ft. There is no separate kitchen. All the food comes from the general hospital kitchen, and there is no separate post-mortem room or mortuary. The wards are heated by radiators and open fires. |